If he was diagnosed that young, it might be a good idea for him to see a rheumatologist specialized in treating Juvenile RA - it is somewhat different than adult onset RA, and those docs understand the nuances and progression. When I was in college over 5 years ago, a rheumatology resident at our Health Service told a friend who had JRA from the age of 6, that he would be dead by 40- How to freak out a 21 year-old! His JRA doc calmed him down, and vehemently disagreed! Glad to say I just saw a picture of him with his grandkids- the years between have not been easy, but he's lead a good life.