Hi,
Welcome to the ehealthforum. I am glad to help you out.
your nephew needs urgent and through evaluation from an orthopedician. One possibility for his symptoms can be osgood schlatter disease in which there is tender, swollen bump just under their knee cap on the tibial tuberosity. Although usually just on one knee, both knees can also be affected. This bump can appear as enlarged knee cap.
It can cause pain during certain activities, such as running, kneeling, jumping etc. He needs to get an x-ray and MRI knees done. Moreover other causes also need to be ruled out.
Treatment includes nonsteroidal anti-inflammatory drugs, such as ibuprofen, rest, putting ice on the area, knee braces and knee immobilizer.
I sincerely hope that helps. Take care.