Ivan Nova leaves with sore elbow

ST. PETERSBURG, Fla. -- The New York Yankees were blown out by the Tampa Bay Rays, 16-1, on Saturday night at Tropicana Field, but they potentially lost a lot more than just a game when Ivan Nova, their No. 3 starter, left in the fifth inning with soreness in his pitching elbow.

Nova was taken to a Tampa, Fla., hospital for an MRI. The results were not immediately available.

"Obviously, we're really concerned," manager Joe Girardi said. "Any time a guy leaves a game because he feels something, you're concerned."

Nova had been hit hard throughout the first four innings of the game, allowing six runs on four home runs -- two by catcher Ryan Hanigan and one each by Evan Longoria and Wil Myers -- but showed no signs of distress until he threw what turned out to be his final pitch of the game, a flat curveball that Matt Joyce lined into left field for a double.

Yankees bench coach Tony Pena noticed Nova shaking his arm after the pitch and alerted Girardi, who went to the mound along with team trainer Steve Donohue. After a brief conversation, during which Nova argued to stay in the game, he was removed before being sent to the hospital for the MRI.

"I was watching every pitch, and I saw it right away," Pena said. "It was funny the way he delivered the ball. And then he started to shake his arm. So I said to Joe, 'Go check this guy out.' If we see anything different from what they normally do, I have to say something."

Neither Pena, Girardi nor catcher Brian McCann had detected any sign that Nova was injured before that last pitch, his 82nd of the game, and none thought the apparent injury was connected to his ineffectiveness.

"It was location. He was up in the zone. His pitches were up," McCann said. "I noticed him wince on that last pitch. That's the only time I saw it."

In 2011, Nova suffered a right forearm strain, and spent some time last season on the disabled list with a right triceps strain. But Girardi said he could not remember Nova previously experiencing any elbow pain. At its most extreme, elbow pain could indicate a torn ulnar collateral ligament, an injury that requires Tommy John surgery and needs a full year to recover.

"You just hope he's fine," McCann said. "We all just hope he's OK."

According to ESPN Stats & Information, Nova's final line -- four-plus innings pitched, eight earned runs and four home runs -- was the first time a Yankees starter had allowed eight runs and four home runs in four innings or fewer in 100 years.

"Any time you lose a starter, it's a big blow," Girardi said. "Obviously, we'll know a lot more about him tomorrow morning, I'm sure, but it's always tough to replace starters."