This is a very special issue of Current Rheumatology Reviews (CRR), which includes a topic that has fascinated me for years. In this issue, Dr. Bucala and his colleagues shed some light on a very important and relatively new disease, i.e., nephrogenic systemic fibrosis. This condition started appearing in the literature approximately 10 years ago with sporadic cases of fibrosis of the skin seen in patients who had renal failure. I remember with great clarity my first case of NSF and my interest in this disease peaked when I realized that we are dealing with a new disease entity. Subsequently, as more cases appeared, the search for a causative factor intensified. Causal relationship between the use of gadolinium-based contrast agents and nephrogenic systemic fibrosis was discovered in 2006. In this issue of CRR, Dr. Stenver describes the crucial role of health care professionals in the discovery of this association and his article provides us a reminder of the important role of pharmacovigilance in the discovery of potential drug toxicities. Reviews of this topic are not commonly present in the published literature and we are very pleased to provide a forum for leading researchers to provide unique and valuable viewpoints that will change the way we practice. For example, Dr. Thomsen and Dr. Morcos in their article shed light on the relatively low-incidence of NSF by using relatively stable gadolinium-based contrast agents. We tote up a mini-hot topic on pain in rheumatic diseases to augment this issue, by presenting an excellent review of the evidence for activation of peripheral and central pain pathways with particular focus on RA and osteoarthritis. Another study describes the neuroimaging studies that have improved our understanding of pain perception in RA, OA as well as fibromyalgia. The potential for an initial inflammatory stimulus leading to ongoing pain and activation is discussed in another article. These articles update us on the current understanding of pain perception in rheumatic disease, and hopefully these studies will have practical application in caring for patients with pain. Lastly, we are also presenting an article about the instruments that assess quality of life and disability levels of the patient with early rheumatoid arthritis, an area of interest to practicing clinicians. We look forward to any comments that you might have about the articles and will continue to strive to bring you high quality articles on important rheumatoid disease topics.