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OBJETIVO: Verificar se a biópsia da sinóvia do túnel do carpo é capaz de identificar patologias sistêmicas que não foram diagnosticadas clinicamente ou por exames laboratoriais. MÉTODO: 46 exames anatomopatológicos da sinóvia dos tendões flexores no túnel do carpo de pacientes submetidos à liberação aberta para o tratamento desta síndrome compressiva foram, retrospectivamente, analisados. Os autores propuseram uma nova classificação para a lesão de acordo com a intensidade do processo inflamatório. RESULTADOS: O exame anatomopatológico mostrou que 56,6% das lâminas foram classificadas como grau I (sem alterações inflamatórias), 32,6%, grau II (infiltrado leucocitário e fibrose discretos, além de hialinose), 4,3%, grau III (infiltrado leucocitário e fibrose intensos, presença de fibrina e neoformação vascular) e 6,5%, grau IV (as alterações acima descritas associadas à presença de calcificação local e células gigantes). Dois pacientes com amiloidose foram classificados como graus I e II e não foram encontrados depósitos de material amilóide em suas lâminas. Dois pacientes portadores de hiperparatireoidismo e outro com insuficiência renal crônica foram classificados como grau IV. CONCLUSÃO: A realização da biópsia da sinóvia do túnel do carpo, além de agregar custos adicionais ao procedimento, não possibilitou o diagnóstico precoce de doenças sistêmicas em pacientes portadores de síndrome do túnel do carpo. OBJECTIVE: To determine whether a biopsy of the synovia of the carpal tunnel is able to identify systemic diseases that were not diagnosed by clinical examination and laboratory tests. METHODS: Anatomical pathology P examinations of synovial tissue were performed in 46 patients that underwent open carpal tunnel release. Anatomical pathology examination with hematoxylin-eosin staining determined the intensity of the inflammatory process and the authors proposed a new classification of the injury according to the intensity of the inflammatory process. RESULTS: The anatomical pathology examination showed that 56.6% were classified as grade I (unchanged inflammation), 32.6%, grade II (leukocyte infiltration and discreetmoderate fibrosis), 4.3%, grade III (leukocyte infiltrate and intense fibrosis, the presence of fibrin and vascular neoformation) and 6.5%, grade IV (changes described above associated with the presence of local calcification and giant cells). Two patients with amyloidosis were classified as grade I and II and no stockpiles of amyloid material were found on their slides. Two patients with hyperparathyroidism and another with chronic kidney failure were classified as grade IV. CONCLUSION: Synovial biopsy of the carpal tunnel did not make early diagnosis of potential systemic diseases possiblein patients with carpal tunnel syndrome, and adds extra costs to the procedure

Anatomia patológica da sinóvia de pacientes submetidos à liberação do túnel do carpo