The diagnosis of reflex sympathetic dystrophy (RSD) relies on clinical evaluation, scintigraphy or MR imaging, and routine radiographs. Because RSD has variable manifestations with a strong psychogenic overlap, it is desirable to have a noninvasive test to determine the presence of RSD to allow for appropriate treatment. MR imaging allows a differential diagnosis between RSD and other bone lesions. It proves to be a reliable technique in showing and characterizing RSD better than radiographic examination and radionuclide study.