Group E remains the only group in which no team is yet to guarantee their place in the next stage, or be eliminated.
Should the Africans draw their match, they must hope the Italians beat the injury plagued Czechs.
But if the USA win, they will also be cheering on last start foes the Azzurri.
Black Stars coach Ratomir Dujkovic is in an atypically bullish mood.
"They have to worry. The USA will suffer because we are strong and we are not afraid of anyone," he said.
"Ghana is young and tough. We won't play for a draw. We always play offensive football and we play to win."
The Serbian coach has stated that he believes the match is the most important one of his life.
Should the Africans win it is likely they will face Brazil, but not even the prospect of the five time World Champions was enough to dampen his spirits.
Life on the line
"Every one of our players would give their lives for a win over Brazil," he declared.
"We're certainly not going out there to play in a half-hearted way."
His mood was echoed by Chelsea’s Michael Essien who will again be a key player for his side.
"We are ready to play anyone. We're not afraid to meet the Brazilians," said Essien. "First we have to deal with the USA. They play good football and they will be tough."
Not turning his back on his team:
While Essien was always going to be a vital player along with captain Stephen Appiah, their importance was increased when they lost their two goal scorers from their victory of the Czech Republic Asamoah Gyan and Sulley Muntari, due to the pair’s collection of a second yellow card each.
The Americans have also been forced to count the cost of their draw with the Italians with the loss of defender Eddie Pope and midfielder Pablo Mastroeni who both saw red in their last match.
The loss of players on both sides was regrettable according the USA coach.
The call of the card
"The cards are excessive," Arena said.
"It's just too much. They have taken some good players out of some games."
He also laid out his game plan which will look to counter the Africans free flowing style.
"Hopefully we can deal with their team speed. That's my biggest concern," the 54 year old said.
"One thing we don't want to do is have a foot race with Ghana for 90 minutes. If we do, we're going to lose a lot of those races."
Despite striker Brian McBride’s stitches still being visible, it was clear the wounds from last Saturday have healed for Team USA star Landon Donovan.
"I'm rooting for Italy for the rest of the week. As far as I'm concerned they are the nicest guys in the world," Donovan said.
"If it's 4-0 for Italy at half-time, I would probably want to know. If not, don't tell me."
A match that promises so much should make it compulsive viewing.