The earliest radiological manifestation of TB of the hip joint is :

Ref: Tuberculosis of the skeletal system by SM Tuli. page 70 - 81 Mercer's orthopaedic surgery fninth edition) by Duthie, Bentley and Dhal page 604Explanation:Radiological findings in TB hipThe earliest radiological sign on X-Rays is a slight loss of bone density (osteopenia) due to synovial edema.In some cases, because of the excessive synovial thickening, soft tissue shadows may be seen.Synovial effusion will be present as increased joint space. This is the first stage of synovitis.In the second stage of early arthritis, in addition to the above, slight diminution of joint space is made out due to cartilage destruction. Localized erosions at the margins may be present.In stage III, gross destruction of the articular cartilage and bony destruction of the femoral head and acetabulum is seen.In stage IV. that of advanced arthritis with pathological dislocation, we see features such as 'wandering acetabulum', protrusion acetabuli' or 'mortar and pestle' appearance.