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Well bless your heart, Peanut! You are definitely hosting quite an autoimmune party, huh? I'm so sorry.   I have RA, and you certainly have hallmark signs of RA. I'm sure that you know the skin rash sounds Lupus-like, but really your bloodwork will steer the differential diagnosis as Lupus and RA and other autoimmune disease share quite a few features.   Speaking from an RA perspective, not swelling isn't uncommon even when your joints are inflammed. Again, bloodwork will be able to reveal any ongoing inflammation. Pain can be present with RA without any visible signs.   It sounds like you have had issues for years. It is possible that you have developed OA as a result of RA, which again is quite common. I don't know your age or activity level, so its hard to know how you or your docs have been conceptualizing all these symptoms for so many years.   Again, so sorry you are dealing with all this.