When I pan I am getting a tick in the video that is bugging the heck out of me. Here's a short video of the issue.

The problem is actually more pronounced than the video shows. Probably from the 30FPS capture.

http://youtu.be/QBSO8rB-QVs

I'm not running many mods:

AWOP, Anti Crash, and Civil Defense Radio

My system specs are in my sig.

I do get a steady 60FPS reported by fraps and Core Temps report nothing higher than 50C

Nvidia setting are all default except Vsync is set to adaptive (half refresh rate) since my monitor refresh rate is 120Hz. and I changed multi monitors to single.

Any ideas or suggestions are welcome.

EDIT: One last thing. I don't have this issue with FO3 and I'm running quite a few more mods.

Now that I think about it one of my FO3 mods is an anti-flicker I wonder if it's the same kind of thing?