CLEVELAND -- Midway through the second quarter of Thursday night's 21-7 loss to the Cleveland Browns, Pittsburgh Steelers wide receiver JuJu Smith-Schuster was face down on the field at FirstEnergy Stadium.

A quarter later, a similar scene unfolded again.

The Steelers lost three of their top playmakers in all -- Smith-Schuster (concussion), Diontae Johnson (concussion) and James Conner (shoulder) -- as the Steelers four-game winning streak ended and their playoff chances dropped significantly.

The game ended in melee when Browns defensive end Myles Garrett ripped Steelers quarterback Mason Rudolph's helmet off after a play near the end zone. Garrett landed on top of Rudolph and Rudolph appeared to initially grab Garrett's helmet. Garrett responded by taking off Rudolph's helmet and swinging it at Rudolph and striking him in the head. Steelers center Maurkice Pouncey also got involved, kicking and punching Garrett.

Pouncey was ejected for a personal foul, and the Browns' Garrett and Larry Ogunjobi were also ejected.

The Steelers, who put two players on injured reserve before the game, lost five more to injuries throughout the course of Thursday night's game.

The loss puts Pittsburgh three games behind the Baltimore Ravens in the AFC North. The Steelers have a chance to make up some ground with a game against the Cincinnati Bengals next week and a rematch with the Browns a week after.

But with the Ravens surging, the Steelers are right back in the hole they worked so hard to climb out of after a dismal September.

Pivotal play: Trailing by a score midway through the fourth quarter, the Steelers had a chance for a tying drive. Instead, on the first play of the drive, Rudolph threw an interception to Joe Schobert on a pass intended for James Washington. Schobert's return gave the Browns the ball on the Steelers' 4-yard line, setting up for an 8-yard touchdown pass from Baker Mayfield to tight end Stephen Carlson three plays later to widen the lead to two touchdowns.

Troubling trend: The Steelers' offense continued its streak of slow starts. Pittsburgh didn't gain a yard on the opening drive as Conner carried the ball twice for a net gain of zero, and Rudolph threw an incomplete pass. It's the latest in a stretch of dismal starts that stretches back nine games. The Steelers have gained a total of 14 yards in the past nine opening drives.

Significant NextGen stat: The Steelers hadn't given up any pass plays of at least 40 yards since Week 1. They gave up two Thursday night: a 42-yard deep ball to Odell Beckham Jr. and a 41-yarder to KhaDarel Hodge.

Quarterback analysis: Handicapped by a thin wide receiver rotation, Rudolph had his worst game as a Steeler. He completed 20 of 41 attempts for 185 yards with four picks and one touchdown -- a throw to Jaylen Samuels out of the backfield to cap a drive greatly aided by Browns penalties. Rudolph became the first Steelers quarterback to throw four interceptions against the Browns since Mark Malone in 1987.