When a doctor orders an MRI or a Magnetic Resonance Imaging study, sometimes the doctor asks for contrasts.  And, the contrast is a metallic ion called gadolinium.  And, gadolinium is usually safe, because the way the manufacturers produce it is covering with a substance that makes sure that it doesn’t come into contact with the inside of the body.  Because, it is a toxic substance.  But, some people have preexisting kidney problems.  And, if so, the gadolinium doesn’t get excreted from the body.  If it doesn’t get excreted from the body quickly enough, then that protective coating can get broken down and gadolinium gets into contact with the inside of the body, and when that happens a really, really debilitating disease can result, called NSF.  Now, people with NSF usually first notice a very debilitating skin disorder.  It can be diagnosed with a punch biopsy, usually a dermatologist does that.  They take a little punch biopsy and look at the sample under a microscope, and they can instantly diagnose whether it’s NSF.  There is nothing else that we know of that causes NSF except gadolinium.