In a transforaminal epidural steroid injection, is the ink supposed to look like a drop or should it spread out in a spray like the size of half a dollar?

Iodine contrast: This may or may not be used with a transforaminal injection. Though, in theory, it would seem that the steroid would flow in a similar pattern to the contrast injected, it doesn't necessarily hold true. I would suggest that about the only benefit that contrast serves is to make sure the injection is not into a vessel. Otherwise, the normal spread of the injection will likely differ from the iodine.

Transoraminal inject: Transforaminal injection is always done under fluoroscopic guidance. Contrast material (ink or dye) is used to confirm that the medicine is placed in the right place and also to confirm that it is not in the wrong place. The spread depends on the amount injected. It could look like a drop if less and other shapes if normal amount is used. It will outline the nerve root in most cases if done proper.

Neither: Neither. The ideal spread will show the contrast dye spread centrally to the epidural canal and laterally highlighting the nerve path producing a 'characteristic' epidurogram.

Transforaminal Inj: In the transforaminal approach to the epidural steroid injection the nerve is coated with the steroid/anesthetic mixture. Usually the dye can look like its outlining the nerve, outlining the epidural space or even outline both the nerve and epidural space. Generally it does not look like a dot or the size of a half dollar.