Here's a pic of the issue and if I ever find out the solution without having to reinstall I'll be sure to post it here for others to use if they have this happen. I can fix any issues with Oblivion myself or usually find the info to do it if I can't, but with Fallout NV I have no idea. I get really sick of having to tweak and fix problems with newer games and long for the days when games just worked. I'm going to be very, very annoyed if I have to reinstall the game and have to download a ton of data in patches and updates. I've researched everywhere I can think of including the Readius mod page where a couple of other people mention the same issue, but no solutions have come up. I use the Readius mod, however if I remove it according to instructions and get the default Pipboy back it is also rotated so I can't see the screen. It's happening with all saves so it's not embedded into the most recent one. Just after I say I have no issues with Fallout New Vegas I have the first crash in 20 plus hours after installing the new patch and creating a new character I really like, and now my Pipboy is rotated 45 degrees when I reload the game.

Fallout new vegas pipboy 2500