To add or subtract expressions, expand them to make their denominators the same. Least common multiple of $\left(b-4\right)\left(b+4\right)\left(-x+a\right)$ and $4-b$ is $\left(b-4\right)\left(-b-4\right)\left(-x+a\right)$. Multiply $\frac{\left(a^{2}-x^{2}\right)\left(b+4\right)}{\left(b-4\right)\left(b+4\right)\left(-x+a\right)}$ times $\frac{-1}{-1}$. Multiply $\frac{x}{4-b}$ times $\frac{-\left(-b-4\right)\left(-x+a\right)}{-\left(-b-4\right)\left(-x+a\right)}$.
Since $\frac{-\left(a^{2}-x^{2}\right)\left(b+4\right)}{\left(b-4\right)\left(-b-4\right)\left(-x+a\right)}$ and $\frac{x\left(-1\right)\left(-b-4\right)\left(-x+a\right)}{\left(b-4\right)\left(-b-4\right)\left(-x+a\right)}$ have the same denominator, add them by adding their numerators.
To add or subtract expressions, expand them to make their denominators the same. Least common multiple of $\left(b-4\right)\left(b+4\right)\left(-x+a\right)$ and $4-b$ is $\left(b-4\right)\left(-b-4\right)\left(-x+a\right)$. Multiply $\frac{\left(a^{2}-x^{2}\right)\left(b+4\right)}{\left(b-4\right)\left(b+4\right)\left(-x+a\right)}$ times $\frac{-1}{-1}$. Multiply $\frac{x}{4-b}$ times $\frac{-\left(-b-4\right)\left(-x+a\right)}{-\left(-b-4\right)\left(-x+a\right)}$.
Since $\frac{-\left(a^{2}-x^{2}\right)\left(b+4\right)}{\left(b-4\right)\left(-b-4\right)\left(-x+a\right)}$ and $\frac{x\left(-1\right)\left(-b-4\right)\left(-x+a\right)}{\left(b-4\right)\left(-b-4\right)\left(-x+a\right)}$ have the same denominator, add them by adding their numerators.