Two hours before Tuesday’s home opener, the Red Sox announced that they’d placed Nick Pivetta on the 15-day injured list with a right-elbow flexor strain.

The move, which is retroactive to Apr. 6, is a surprising and crushing blow for the Sox, who already lost Lucas Giolito for the season. And for Pivetta, who will become a free agent in the coming offseason, the ramifications of a potentially serious elbow injury could be significant. Until now, he’d been one of the game’s most durable starters, pitching between 133-179 ⅔ innings in five of his seven 162-game seasons.

Since arriving in Boston at the 2020 trade deadline, Pivetta has been the club’s healthiest starting pitcher by far. Between ’21-’23, he pitched in 102 regular-season games, including 79 starts, averaging 26 starts and 159 innings per year. In ’22, his 33 starts tied for the Major League lead.

The right-hander, 31, dominated in his first two starts of the season, striking out 13, walking one, and only giving up a solo home run in 11 innings of work.

Elbow injuries are running rampant in the game this year, leading to conflict between the league and Players Association. In early March, Giolito underwent internal brace surgery to repair a UCL tear and flexor strain. Barely two weeks into the regular season, several pitchers around the league have seen their campaigns cut short by Tommy John surgery.

To fill his spot on the active roster, the Sox have recalled Brennan Bernardino from Triple-A. The left-hander, who pitched 2 1/3 innings for Seattle in his brief ’22 debut, was a steadying force on Boston’s pitching staff last year, making 55 appearances, including six starts (as an opener) and eight games finished. Over 50 2/3 innings, he posted a 3.20 ERA with 58 strikeouts, 18 earned runs and 18 walks.