Gary Medel's first Inter goal secured a 1-0 win over 10-man Roma at San Siro, sending Roberto Mancini's side top of Serie A.

The Inter coach dropped Mauro Icardi - last season's joint-top scorer in Serie A - due to a prolonged barren spell, but the Chilean was on target to make it two successive wins for his side.

It was a strike that came against the run of play, with Edin Dzeko - whose goalless run now stands at nine Roma outings in all competitions - unable to convert either of two earlier opportunities when Rudi Garica's men had control.

Inter had Samir Handanovic to thank for keeping Roma off the scoreboard and the highlight of the Slovenian's heroics came just after the hour-mark with a fine quadruple-save.

Roma pushed for an equaliser but was unable to find it and a red card for Miralem Pjanic - who will miss next weekend's derby with Lazio as a result - in the 73rd minute effectively brought an end to its hopes.

Mancini's side remained composed to move to the top of Serie A with its sixth 1-0 victory in Serie A this season, deposing Roma, which had gone into the weekend at the summit.

Mohamed Salah quickly set about displaying the abilities Inter missed out on after failing to capture his signature ahead of this season, causing problems with his pace and dribbling and looping a header over the top in the eighth minute.

Roma had taken charge of the match and was denied an opener in the 15th minute when Handanovic got down to parry Dzeko's header clear of the bottom corner.

Rudi Garcia's side was well on top but did not make the most of a glorious chance in the 23rd minute when Handanovic saved Maicon's powerful drive and Dzeko's follow-up effort from inside the six-yard box was deflected wide by Danilo D'Ambrosio.

That miss proved costly as Medel drilled a fine strike into the bottom corner from 25 yards, putting Inter ahead against the run of play.

Medel was forced off through injury early in the second half - Geoffrey Kondogbia replacing him - and Roma took a greater hold of possession.

Six minutes after the restart, Handanovic denied Dzeko once again, smothering his header after a corner.

The Inter keeper's fine display continued when, in the 61st minute, he kept out Pjanic's 20-yard strike, saved Salah's follow-up effort with his legs and made two more reflex stops to keep the ball out.

Roma continued its pursuit for a leveller but its hopes were dealt a severe blow when Pjanic was shown a second yellow card for deliberate handball.

As Inter sought to kill the game off, Wojciech Szczesny brilliantly denied Marcelo Brozovic, but it mattered little as Inter hit top spot, although the tight nature of Serie A's title race could see Napoli or Fiorentina overtake it on Monday (AEDT).