BALTIMORE -- José Alvarado toed the rubber as a starter for the first time in his big league career Saturday and was merely looking for a spark. He was on the mound at that time of the game because Rays manager Kevin Cash saw how opening with some of his other scuffling relievers this year had helped set their seasons straight. The need was present for Alvarado only because of how injuries and personal matters have ravaged his season.

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Instead of a steadying performance, the Rays got the worst possible outcome. With players still emptying the clubhouse at Camden Yards less than an hour after the game, Alvarado was placed on the 10-day injured list with left elbow inflammation after the 7-1 loss to the Orioles. It was an ailment that arose after his one-third of an inning was over, he and Cash said, and it’ll require him to fly back to St. Petersburg on Sunday for an MRI on Monday. The next steps will become clearer then.

“I felt fine at the beginning of the game. It wasn’t something that was really bothering me much,” Alvarado, who returned from a right oblique injury just nine days ago, said through team translator Manny Navarro. “But I like to compare it similarly to death. It’s something that you don’t expect to happen. Injuries just kind of happen, and they just kind of linger.”

As a corresponding move, the Rays activated Joey Wendle from the IL after he had been rehabbing with Triple-A Durham from right wrist inflammation.

It has been a trying season for Alvarado both on and off the mound. He entered the year with a career 1.83 ERA in 93 2/3 innings, but that number sits at 4.80 in ’19. His season hasn’t been aided by his injuries, which include the oblique injury that sidelined him a month from July to August before this elbow ailment. And it hasn’t been aided by his off-the-field matters, Cash added pregame Saturday, which included a weeks-long stay on the restricted list to tend to a personal matter in Venezuela.

It’s too early to tell just how much time Alvarado will miss. Although the team trainers honed in on one specific breaking ball he threw out of his 24 pitches -- only nine of which were for strikes -- Alvarado didn’t believe there was a singular cause to his injury.

Regardless of how it plays out, the Rays believe they lose a vital cog to their bullpen when Alvarado is either not right, as has been the case since his latest return, or on the shelf.

“Look, we’re a better team when Jose’s throwing the ball well,” Cash said. “We’re a better team, and we’ve seen how he can contribute and really impact the back end of our bullpen, the front end -- whatever it is. This is unfortunate. It’s been an unfortunate season to date. We’ll see when the doctors check him out … and we’ll have some news, probably, in the coming days.”

“Coming back from an oblique thing is tough, and then to have your elbow barking a little bit is tough, too,” said catcher Travis d’Arnaud, who added that he did not see anything awry with Alvarado during the outing. “Hopefully, it’s not too serious and he can be back before the year is over, because he's a big part of the bullpen and a big part of the clubhouse, too."

Alvarado walked the first Baltimore batter on four pitches, threw two wild pitches -- one that scored a run -- and loaded the bases before his departure, which came after Cash approached mound in the middle of a 3-0 count.

“He had no chance to throw the ball over the plate at that point,” Cash said. “Didn’t want another run to come in at that point.”

So Alvarado abided, although against his wishes, and headed back into the clubhouse where he presumably alerted the trainers of his injury before the decision was made to send him to St. Petersburg for further testing. He was unhappy, both with his early exit to a game he hoped would revive his season and to the news that no hurler wants to have to report.

“In this business and in this game, I’ve matured a lot,” Alvarado said. “I could very easily have been upset, I could have thrown things, but I know it’s part of the game and I know I have to control those emotions. I like being out there, I like being able to compete for my team and the fans, but that's just the way it goes.”

It helped to see Austin Pruitt throw the ball well as Alvarado’s replacement, quickly escaping a bases-loaded jam with a double play via Pedro Severino the moment he entered. But Pruitt himself would struggle, too, allowing three homers, one of which was a grand slam to Severino in the third inning.

It helped, but it did not do much to quell the bigger worry -- if Alvarado can contribute to this team in the near future or this season.

“I didn’t expect it, but it’s something that happened,” Alvarado said. “And because of those injuries that have caused me to struggle, I just have to hope there’s nothing major going on and just hope that I can come back and return.”