Frequent Bruising\Large bruise with white area

My son is 7 and has in the past (birth to 3) been subject to decreased immunoglobulins and resistant infections.  That has mostly cleared up with age.  However, around 5-6 my son had an occasional high Antinuclear Antibody (1240) with swollen lymph nodes and thyroid, and what appeared to be a butterfly rash.  I took him to a Pediatric Rheumatologist who wasn't concerned with the ANA (did a retest - fine).  His pediatrician felt an enlarged thyroid again this Summer and retested his thyroid function - fine.  

Since then, I've noticed that from his knuckles upwards to the tips of his pinkie fingers are growing and a slanted inward angle, and the bones (i.e. the knuckles at the base) in this thumbs are protruding substantially outward.  He's also been covered with bruises this summer as he's been a typical boy and playing outside.  Tonight, when I went in to check on him in bed I noticed a rather large bruise on the outside\back of his left knee which seems to be protruding somewhat and has an almost raised white area in it.  He was really complaining about his leg last night in the car.  So...with a history of:

some increased ANA;
enlarged (yet negative blood test for) thyroid and lymph nodes;
recent bilateral unusual growth in bone structures in his pinkies and thumbs; and
frequent bruising and now a large bruise with a large raised white area in a somewhat unusual place...

I'm at a loss for which would be the most expedient way to be seen by which practicioner?  Sadly, our pediatrician who is associated with his doctors at our local Children's Hospital will very soon stop accepting Blue Cross Blue Shield, so the typical "just see your pediatrician for a referral" idea is really not the best option at the moment.  My other problem is that, as a single mom, I don't have the luxury of waiting months for an appointment to take off work and hear "oh, you are in the wrong place and need to see [name]" and then wait 6-9 months for that appt.  Who is the most bang for the buck provider?