Cook the pasta:

• Cook the rotini pasta according to package instructions in salted water. Drain and set aside, reserving about 1/2 cup of pasta water.

Brown the sausage:

• While the pasta is cooking, heat the olive oil in a large skillet over medium heat. Add the Italian sausage, breaking it up into small pieces with a spoon. Cook until the sausage is browned and fully cooked through, about 5-7 minutes.

Sauté the onion and garlic:

• Add the diced onion to the skillet with the sausage and sauté for 2-3 minutes until softened. Add the minced garlic and cook for another 30 seconds until fragrant.

Add the tomatoes and seasonings:

• Stir in the diced tomatoes with green chilies (or plain tomatoes with chili flakes), chicken broth, dried oregano, and crushed red pepper flakes. Let the mixture simmer for about 5 minutes, allowing the flavors to meld together.

Make it creamy:

• Reduce the heat to low and stir in the heavy cream. Let the sauce simmer for 2-3 minutes until it thickens slightly.

Combine pasta and sauce:

• Add the cooked rotini to the skillet and toss to coat the pasta in the creamy sausage sauce. If the sauce seems too thick, add some reserved pasta water, one tablespoon at a time, until you reach the desired consistency.

Season and serve:

• Taste and adjust seasoning with salt and pepper as needed. Serve the Spicy Sausage Rotini hot, topped with grated Parmesan cheese and chopped parsley if desired.