Stage I or early RSDS Pain is more than would be expected from the injury, and has a burning or aching quality. It may be increased by dependency of the limb, physical contact, or emotional upset. The affected area becomes edematous, may be hyper- or hypothermic, and shows increased nail and hair growth. Radiographs may show early bony changes. Duration is usually 3 months from onset of symptoms.
Some patients stay in one stage or another many months or even years.
They may never progress or may progress quickly to late stage. Stage II or established RSDS Edematous tissue becomes indurated. Skin becomes cool and hyperhidrotic with livedo reticularis or cyanosis. Hair may be lost and nails become ridged, cracked, and brittle. Hand dryness becomes prominent and atrophy of skin and subcutaneous tissues becomes noticeable.