Localized underglossing of the right 4th anterior rib may be a possible, but not absolute, indication of a fracture, or it may be due to osteoporosis. The underglossing of the cortex of the rib indicates the presence of bone damage, and whether there is a fracture or not should be judged in conjunction with clinical symptoms, such as bone rubbing, local deformity, abnormal activity and imaging. If there is a suspicion of right anterior 4th rib fracture, it is recommended to carry out external fixation and local braking, and symptomatic conservative treatment can be. In some elderly people, due to osteoporosis and other reasons, there may also be a lack of smoothness of the bone cortex. It is recommended that patients with right 4th anterior rib fracture have regular checkups to clarify the recovery of the rib area, avoid strenuous exercise and increase nutrition to promote recovery.