So I was reading a lot about this case in the last day or so (was going through a UM wiki and decided to see if I could find anything more about it) and stumbled upon this thread and read through it (all 17 pages!) so I registered and figured I'd post...
As people mentioned about medication she may have had for her knee, I looked up various arthritis medications and found that some of them can cause disorientation as a side effect. Some of them more commonly if it's a new prescription, some of them actually after the medication has been taken for a while, and most commonly among certain age persons. I'd wonder that if they were able to do a toxicology (as mentioned not likely if it were only bones found) if maybe any prescribed medications would have been overlooked? Though many of the sightings in Philly were discounted as her lookalike there were a few according to some of the articles I've read (insomnia is terrible and I didn't save all the links) that seemed promising but described her as seeming disoriented. According to the people who saw her in NC she seemed to be acting fine, but the one who spoke with her said she'd mentioned that her husband and her had been in Philly but she'd decided to come down there. Didn't they find that odd? It's not like it's just a quick drive or something. The fact that she bought the toy seems to indicate some sort of confusion on her part (jmo) although it could easily depend on the toy. My mom's ex collected certain tractor toys, so no further mention about it doesn't really give much to go on. However, I think her forgetting her ID is a sign of some disorientation/confusion starting in by that point.
Also regarding their relationship, I read a few articles that mentioned her family considered the marriage good. The only thing I read about it being problematic was that her friend thought so and that Philly LE thought maybe it was the case. It seems odd to me that after 10 years of dating, 3 years of living together, that she'd be willing to marry the guy if they were having issues? Especially if she'd had prior marriages go badly.
Also, regarding the car, I looked into it and it's not impossible to rent cars even today without a credit card. Even Hertz will rent you a car without one if you apply for a cash thing, though I'd hazard a guess that requires a credit check. It's quite possible at the time more rental places were happy to rent a car without a credit card, and depending on where she got it they may never been able to find it. I am on the fence about whether or not her killer would have rented the car, as the people who claimed to see her with the car didn't see someone else as far as I recall reading.
With regards to the backpack, while it's possible she bought a new one after the red one fell apart, does anyone think perhaps it was dragged off by animals? Especially if she was keeping those purchased sandwiches in there, or some other food... Or perhaps that was taken by the killer along with the wallet? Her jewelry was found later, and somebody on this thread mentioned taking off their jewelry if it's possible they'd lose it. Perhaps she'd stuck it in the backpack and the backpack was dumped in a hurry to locate the wallet, explaining why the jewelry was not on her, and things like a flashlight and book were found nearby?
A few random things that I personally thought were odd:
Her family said she wasn't girly which made it normal that she wouldn't wear makeup. If this is the case why would she be inspired to buy her husband flowers, like he said? Is it some sort of joke between them? I've never had a girl give me flowers, even the "girly" ones, and I'm admittedly a more sensitive type of guy.
As others have said remembering somebody after 6 months seems odd, even if she stood out, who would remember so many specific things? Somebody on the thread said it was a tourist area, which means the shop owners and such would likely see all sorts of people they wouldn't see as regulars. Why would LE take their sightings so seriously, even with such specifics mentioned? Unless, perhaps, they got hold of some of the news about her disappearance and remembered maybe thinking it seemed like her, but then why wouldn't they mention it, especially if they knew things like she were from Philly, until after police found her? Perhaps they saw somebody resembling her, and after the fact sort of made up stories to reinforce their own belief that they'd seen HER and not somebody else?
In one of the articles posted in this thread I read that somebody "across the road" from where she was found (I believe that's what it said) had mentioned that it wasn't someplace a hiker would have gone who wasn't from the area. Why wasn't this mentioned in other articles? Was this only one person's opinion that an out-of-the-way hiking trail would see non-locals?
I also wonder what ever became of the inquiry into her finances. I will note that, while he was her husband, if they kept separate accounts he likely wouldn't have personal access to that information. Also, does anyone know when VeriFone and/or Hypercom terminals became popular in the more rural areas? I know they've been around since the 80s but in the more rural areas I grew up I remember still seeing imprinting machines at least into the early 90s (my family didn't use credit cards so IDK when they went out of common use, even in more rural areas). If places were still using imprinters (I guess some places still use them) it may not have been noticed by a place like a car rental that the card had been reported missing/stolen until after the fact.
Anyway, hope this post wasn't a bad first impression. I guess I asked more strange questions than anything, some of them probably kinda stupid questions. Just a very strange mystery.