I can't tell, the picture is small

It's a thumbnail. Click on it to enlarge.

OOh! Looks like you're getting a crest forming on your E. runyonii 'Topsy Turvy'

That would be so cool! Should I remove the upper growth to give it more room or just leave it be?

Yes, Karyn, that is, in fact, a crest forming on your Echeveria runyonii 'Topsy Turvy'. I would let it get larger before removing it. I will tell you the crest will tend to revert back to the non-crested form putting out lots of "normal" rosettes. But go for it and enjoy!

Karyn,
Here's a link to one I removed from the mother non-cresting plant after a years growth as a crest.

Here is a link that might be useful: Echeveria runyonii 'Topsy Turvy' f. cristata

Julie that's interesting looking. I'm glad to find that it's not diseased. What causes a plant to develop a crest?

The cause of cresting is not absolutely known, but biologists think the cause may just be damage to the growing point such as, genetic mutation, freezing, burning, bugs chewing, or the growth point is poked with something like a needle.

...or cored with a red-hot piece of rebar which had been heated in a fire and held in the jaws of a pair of 12" Vice-Grips as the tip seared the meristem...wait, that's intentional pup production.

Cresting is thought (mostly) to be a virus, as yet unidentified.

This plant did have a terrible mealy infestation over the winter. I wasn't able to completely clear it up until it had been outside for several weeks.