The results were nothing short of alarming. When Daisuke Matsuzaka walked seven in 4 1/3 innings, allowing five hits and five runs to the Orioles, the Red Sox felt that it was time to have the right-hander checked out to see if there was a physical problem.

And so, on Tuesday, Matsuzaka was sent for an MRI on his right elbow. The Sox were awaiting the results to determine if a roster move might be made, with the team prepared to move “expeditiously” (in the words of manager Terry Francona) to DL him and call up a reliever (Michael Bowden would be an obvious candidate — he has a 1.59 ERA in 22 2/3 innings for Triple-A Pawtucket) prior to Tuesday’s game.

UPDATE: The Sox intend to place Matsuzaka on the disabled list prior to the next game, at which time Bowden will be added to the roster.

“Talking about [Matsuzaka's] elbow, whether it’s sore or he’s afraid to get to a point where it’ll get sore, that’s what we’re trying to figure out. So we got the MRI and hopefully in the next hour or so we’ll have something to kind of go by,” Francona said at 4 pm. “There’s no reason to really do anything until we get the results back and talk to the medical people. Obviously, if there’s a need to do something, we’d like to do it expeditiously – get that – because maybe we could get a reliever in the meantime or somebody to help us through. We’re trying to do it in timely fashion.”

With Matsuzaka’s elbow being checked and John Lackey having been placed on the disabled list on Monday for his elbow strain, it is a time when the Sox’ rotation depth will be tested. The team is comfortable that in Tim Wakefield (scheduled to start on Tuesday against the Orioles, in place of Lackey) and Alfredo Aceves, it has viable options.

“I don’t know that any team wants to go seven, eight deep, especially in a two-day period, losing two-fifths of your rotation. Wake has done it for a long time. Wake’s done it since I was a little kid,” joked Francona. “Actually, Aceves, we sort of maybe wanted to see what he could do as a starter. That’s why we signed him. Every time we send him down, we keep telling him to get stretched out because he might be a starter. We don’t like the reasons why. But we think we’re going to be OK.”

Of course, if both Wakefield and Aceves end up in the rotation, it would have a cascading effect on the bullpen. Wakefield has been a long man, while Aceves has emerged as something of a setup man to pitch either in the sixth or seventh inning (as he did on Sunday night in the win over the Yankees) or when the team is trailing in a close game (as he did in earning the victory on Monday night with three innings against Baltimore).

“He’s kind of taken that sixth, seventh type inning where he can face lefties and righties. That’s something to think about,” said Francona. “We have to figure out a way to get around that.”

Of course, the Sox appear close to getting at least one option back. Dan Wheeler, who had an 11.32 ERA in eight games before landing on the DL with a calf strain, is eligible to come off the DL on Friday. He has thrown 2 2/3 shutout innings in Pawtucket on a rehab assignment, and Francona said that there is no reason to expect that he won’t come off the DL when he is eligible to do so.

Bobby Jenks remains a bit further away from returning, though he threw on Tuesday from 60 feet on flat ground. He’ll increase that distance on Wednesday, though given that he went 11 days without throwing, he will almost surely require a rehab assignment before he’s ready to return to the majors.

“When you’ve got a no-throw for a while, I don’t know how fair that would be not to [have him take a minor league assignment],” said Francona.

As for Lackey, he will spend the next few days “down,” in Francona’s words. It is not known precisely when he will begin throwing again. Francona said that the starter had an MRI that had revealed the strain, but that it was unclear whether he was dealing with the condition during his mot recent outings, which featured particularly poor results.

“There’s a lot of gray area there. If you talk to a starting pitcher, if they make 35 starts, I bet they’ll tell you they feel good physically for about six or seven,” said Francona. “So, you know, I actually, what I told you guys yesterday was about as honest as I can be. We didn’t feel a rush to do anything because we knew that we could cover the spot today [with Wakefield]. If he was OK, we were going to let him pitch. We know he’s been having a rough time, but we also know that he’s a pretty good professional pitcher and we feel like he’s going to turn it around. Now, all of a sudden, you start about someone being tender or sore or hurt, that makes it a little bit tougher. Then you’ve got a guy who wants to pitch through it. We respect that. So we put our heads together, talked with the medical people, talked with Lack and took it out of his hands.

“That would be terrific if this little shut-down really helps him, he feels good and he starts throwing, is ready to come back right when it’s time to come off. I don’t know if that’s the case. I hope it is.”