Just to play devil's advocate, why would/should the medical staff examine the elbow when the player is complaining about a shoulder issue?
There is a major difference in location between rotator cuff weakness and a bruised humorous. Also if Pavano has had it before, couldn't have brought up his opinions with the doctors?
If I was them I would do both, every time. In high school I had shoulder/lat weakness that cause me to drop my elbow and it messed with my elbow. I also broke my hand and had hand/wrist weakness. The doctor said I was good and didn't need any rehab, so most any high school senior would do, I went out and started throwing, my first bullpen session I had a very sharp pain in my shoulder and I was done for the year because I was overcompensating for my wrist with my shoulder.
Moral of the story: it is a decent idea to check both on the chance one caused the other. In this case maybe the bruise caused the shoulder or throwing with shoulder issues caused the bruise.