Hi Thanks for choosing HCM for your query. I appreciate your concern for your mom. I have gone through the case history in your query. The features described in the history are suggestive of Rheumatoid arthritis, but since she has developed rash over the face and the thighs another possibility is Systemic Lupus Erythematosus. Rheumatoid (RA) factor may be negative in 30% of patients of suspected Rheumatoid arthritis. She needs to investigated like ESR, CRP, ANAs, Renal function tests, Blood clotting times, urine analysis, etc. to conclude a diagnosis. Meanwhile giver her some NSAID pain killers along with PPI like omeprazole to combat the acidity related side effects. A physician/Rheumatologist consultation is recommended. Assuming that she has achieved menopause, the best treatment options could be Once weekly administration of oral Methotrexate along with folinic acid. Other option is Hydroxychloroquine which is also effective. If the response to Methotrexate is inadequate, other drugs like Infliximab (which is given intravenously) may be thought of. Hope your query is explained. Kindly rate the answer, if you are convinced. Best regards.