He will get another one Sunday or Monday. This time, doctors will assess whether Howard further damaged his left knee while playing in pain the last couple of months. They will decide whether he needs surgery or if rest will suffice. Either way, Howard will miss the two weeks that will determine whether the Phillies are buyers or sellers at the trade deadline.
If they are the latter, then Chase Utley could be one of the commodities shipped away. That would truly signal the end of this era of Phillies baseball. Howard, Utley, and Jimmy Rollins - you may add Carlos Ruiz if you wish - have been the hub of this wild spinning wheel of an era. The moment that core is broken up, the era is officially over.
It has been slipping away, of course, for some time. It has been three years since Howard and Utley represented the Phillies in an All-Star Game, an incredible eight years since Rollins was selected.
Utley hasn't been right physically for the last two-and-a-half seasons. But really, if you charted the Phillies' decline, it would line up almost exactly with Howard's physical troubles.
Howard first started having pain in his left heel late in the 2011 season. The Phillies, who won a franchise-record 102 games that year, were just 15-14 after Sept. 1 - about the time Howard started hurting. They lost their first-round playoff series to St. Louis, and Howard tore his Achilles tendon while making the final out.
He hasn't been right since, and neither have the Phillies. This is not a coincidence.
And this probably helps explain the too-long delay in shutting Howard down. With Utley and Ruiz both making trips to the disabled list, the Phillies have been scuffling along. Howard first started having discomfort in his knee about May 4, general manager Ruben Amaro Jr. said.
At that point, Howard was hitting .284 with an on-base-plus-slugging percentage of .815, five home runs, and 18 RBIs. Between then and May 19, when he had a cortisone shot, he hit .149 with a .434 OPS and one homer.
Since getting the shot, Howard has hit .289 with an OPS of .861, five homers, and 21 RBIs. Not his best stretch, but enough to persuade the Phillies to let him play on.
"He was working through it," Amaro said. "It got to the point where we feel it's time for him to get off of it and make sure we take care of it. He hit the long home run [Friday night], so he was performing. But it obviously got to the point where he was not able to play and the discomfort was too great."
This is a difficult area. Howard had a cortisone shot in his heel in 2011, played in pain, and wound up tearing the Achilles. The Phillies have conceded that the knee trouble could be a compensation injury. Logic suggests that playing hurt, especially with another cortisone shot masking pain, could lead to another injury.
"We can't just think about the short term," Amaro said. "We have to think about the long term with Ryan as well. We'll be pretty conservative with it. If he needs surgery, we'll take care of it. If he doesn't, we'll try to rehab it and get him back."
The latest MRI exam will reveal whether more damage was already done.
It won't show whether Howard will ever again be the 40-homer, 120-RBI guy at the center of this championship era. It won't show whether Darin Ruf can establish himself as a legit major-leaguer.
Only time can reveal that. And time is not Howard's, or the Phillies', friend.
Contact Phil Sheridan at email@example.com. Follow on Twitter @Sheridanscribe.