I'll see if I can improve it, the thing is that the sprite of him holding it and his sprite as an icon are different sprites, the other one is kind of diagonal

I really like the way it looks when Isaac is holding it but the icon of the item looks kinda wonky to me.

ah, ok

And no, it's not a lance, it's actually a spear

In fact, if you search on Google, you will see that the Spear of Destiny is actually just a piece of the tip of a real spear, so in practice what we use in the game would be like the tip of the spear, but I always found its sprite strange, for me it is a sword

not to be that guy but i think the spear of destiny is supposed to be a lance, so makes sense why it looks like that