In a large cast iron pan or skillet, add ground beef, onions and garlic. Cook until no longer pink and onions are translucent. Drain, return to pan.
Sprinkle seasonings, salt and pepper, red pepper flakes, over meat followed by hot sauce, tomato paste and flour. Stir.
Pour milk and beef broth into pan, stir.
Add macaroni noodles, stir and bring to a boil.
Cover, reduce heat to low and cook for 10 minutes or until pasta is tender.
Sprinkle with cheese, stir until melted, then add sour cream, stir and enjoy.
Recipe adapted from The Darling Gourmet