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Lori, I am not a doctor but I can honestly say that I have experienced this.  Five years ago I did not test positive for anything even though I have severe pain and swelling all over my body.  Three years ago I tested positive for both ANA and Rheumatoid Factor.  I have also spoken with many people who have received a diagnosis of RA despite their negative test results.  The truth is that nobody knows your sisters body as well as her sister.  And if she feels something is going on there, the she probably is right.  Don't let her give up on fighting for a diagnosis.  If I would have given up when the doctors told me nothing was wrong, then I would be in a wheelchair right now.  Encourage her to keep going until she finds a doctor that she feels comfortable working with.  And make sure she is able to express her concerns to her doctor.  She is very lucky to have your support.  Keep it up!  Good luck, and best wishes!
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