Rheumatoid Arthritis (RA): This is a common autoimmune disorder that often presents with symmetric, chronic swelling in the hands, among other symptoms. The chronic nature of the swelling and its bilateral presentation make RA a leading consideration.

Osteoarthritis: Although more commonly associated with asymmetric joint involvement, osteoarthritis can cause chronic swelling in the hands, particularly in the distal interphalangeal joints and the base of the thumb.
Psoriatic Arthritis: This condition can cause swelling in the hands, often accompanied by skin changes typical of psoriasis. The swelling can be asymmetric but can also affect both hands.
Systemic Lupus Erythematosus (SLE): SLE is an autoimmune disease that can cause joint swelling, among many other symptoms. Hand swelling in SLE can be part of a broader spectrum of systemic symptoms.

Scleroderma/Systemic Sclerosis: This autoimmune disease can cause skin thickening and swelling in the hands, which can lead to limited mobility and other systemic complications if not recognized early.
Mixed Connective Tissue Disease: This condition overlaps with lupus, scleroderma, and rheumatoid arthritis and can cause hand swelling as part of its presentation.
Hypothyroidism: Although less directly associated with hand swelling, severe, untreated hypothyroidism can cause generalized swelling (myxedema), which might be noticed in the hands.

Sarcoidosis: A condition characterized by the growth of granulomas in various parts of the body, which can rarely cause swelling in the hands if the granulomas form in the joints or soft tissues.
Amyloidosis: The deposition of amyloid proteins in the body can lead to swelling and other symptoms. Hand swelling would be an unusual presentation but could occur, especially if there's involvement of the nerves or soft tissues.
Hemochromatosis: This genetic disorder leads to iron overload and can cause arthritis and swelling, although it's less commonly considered as a primary cause of bilateral hand swelling.