The potential loss of David Price for any extended period of time not only dramatically changes the Boston Red Sox, but also the landscape of the American League East.

Price underwent an MRI on Wednesday after experiencing elbow and forearm soreness during a simulated game, and was sent to Indianapolis for a second opinion from surgeon Dr. James Andrews.

While the results during Price’s first season in Boston weren’t what the 2012 Cy Young winner expected, there’s no denying that the left-hander was still a horse for the club. Price went 17-9 with a 3.99 ERA and 1.20 WHIP across a major-league leading 230 innings last season, striking out 228 batters.

With Rick Porcello coming off a breakout Cy Young season and the addition of Chris Sale, the Red Sox boasted an enviable top three that made them the early-season favorites to win the AL East. But if Price isn’t able to pitch this season, the ramifications will be felt throughout the organization.

More pressure on the offense

The acquisition of Sale was not only meant to enhance the pitching staff, but it was also designed to take some of the pressure off of an offense that lost David Ortiz.

Boston scored the most runs in the majors last season, and while they still should field a dominant offense, losing an arm like Price’s lessens the margin for error.

The Red Sox benefited from a healthy core in 2016, with Mookie Betts, Xander Bogaerts, Jackie Bradley Jr., Dustin Pedroia, Ortiz, and Hanley Ramirez all playing more than 145 games. They’ll need to remain healthy in order to have a shot at replicating that strong offense.

More strain on the bullpen

Price completed at least six innings in 27 of his 35 starts last season and failed to reach the fifth inning on just two occasions.

Losing an innings-eater like Price will put more strain on a bullpen that enters the spring with some concern. Closer Craig Kimbrel battled control issues and missed time with a knee injury in 2016, Tyler Thornburg will have to adjust to the AL East and has been terrible early on this spring, and Joe Kelly – while good in his limited experience as a reliever – is a wild card in the pen.

Having Price every fifth day allows John Farrell to manage his bullpen differently knowing his starter will likely give him at least five innings, but without him, it dramatically changes how the skipper will utilize his pen.

Injury concerns already exist with the rotation

The Red Sox already entered the spring with question marks at the back end of the rotation, with Drew Pomeranz, Steven Wright, and Eduardo Rodriguez all nursing ailments.

Pomeranz received a stem cell injection in his pitching elbow in October and has yet to throw a simulated game this spring.

Rodriguez will make his first start of the preseason Thursday amid concerns with his knee. The 23-year-old missed significant time last campaign with injury issues and tweaked his knee during winter ball.

Wright was an All-Star for the first time last season but missed the final month with a shoulder injury suffered diving back into second base while serving as a pinch runner. The knuckleballer says he feels 100 percent but has also yet to start this spring.

Exposes lack of depth

Red Sox president Dave Dombrowski believed that the club had enough starting pitching depth when he traded Clay Buchholz and his $13-million salary to the Phillies this winter, but it didn’t take long to expose the lack of major-league-caliber arms in the system.

Henry Owens can’t seem to harness his command enough to become a reliable starter, while minor-league signing Kyle Kendrick and minor-leaguer Brian Johnson have each been roughed up in their spring appearances. Roenis Elias had some success in Triple-A last season, but has yet to put it all together during his short time in the majors.

Due to their proximity to the luxury-tax threshold, the Red Sox don’t have much room financially to go out and acquire another pitcher should Price be lost for significant time.

Unlikelihood of an opt out

Price has an opt-out in his contract after the 2018 season that allows him to forfeit the remaining $127 million of his deal in order to re-enter free agency.

Should Price miss significant time with an injury this season, it’s likely that he won’t opt out and will finish out his contract with the Red Sox – which expires in 2022.

While the Red Sox fully intended for Price to be around for the duration of the deal, there will be plenty of concern surrounding the rest of Price’s tenure in Boston if he suffers a major injury at 31 years old in year two.

(Photos courtesy: Action Images)