Spina bifida occulta (card in question) does not typically have any visible defect per AMBOSS (https://next.amboss.com/us/article/el0xDT#Z73fcb3995038f1aa8da080ccce24688f).
This image clearly shows an open spina bifida defect. While this isn't the purpose of the card per se, I don't think this is the best image to use.
Image from nid:1480550550310 could be used, but it seems like it has a lot going on when the card itself isn't really testing whether it's open or closed etc. I think that cropping out the ultrasound image could be useful. However, even that may be a little confusing since the card is testing the location of the lesion and not what exactly is outside the body (which is tested by other cards).