Conversation: The conversation between human and AI assistant.
[|Human|] 12 year old boy. In November of 2012 he developed a painful right knee with mild swelling. There was no history of trauma. Radiographs and MRI of the knee were normal. Lyme and autoimmune profile were negative. Normal CBC and chemistry. It resolved late December without treatment. Sudden onset of chronic frontal headache on January 13, 2014. Pain is described as pressure with occasional ice pick spiking. There is chronic nasal congestion and hyperesthesia over the entire body. His joints crack often, causing pain. MRI, MRA and MRV normal with the exception of congenital sinus abnormalities which were thought to be incidental. No response to IV DHE, baclofen, hydroxyzine, tizanidine, ketorolac, indomethacin, acetominophen, ibuprofen, methylprednisolone. Currently on Bystolic and topamax with little response. Light and sound make headache worse. Minimal sleep apnea not thought to contribute (Pulse ox gets down to 97% during apnic episodes)
[|AI|]  Here in headline you have asked for treatment for swollen knee pain. And in your explanation you have mention many other issues like headache and sinus problem too. You have mention patient have taken many medications, but I suggest when MRI showing every thing normal for head and if it is only sinus. Then for that you can give him multi vitamin and multi mineral supplement from natural source along with some exclusive vitamin c supplement. And also ask him to do yoga and paranasal regularly for some more relief. For sinus if it does not work then visit a good ENT doctor for further examination and treatment. For knee pain again if MRI is normal and there is no history of trauma then it can be knee cap movement disorder. I suggest visiting a good or tho and physio for further examination and treatment. Here in physio they will also help with different exercises which will help to correct the biomechanics of knee joint. As well electron therapy along with heating will help for some more pain relief. You can also use on your own cold pack at home to reduce inflammation and swelling. Follow all above steps, and I am sure it will be helpful. Take care.