Hey mate,
In these situations, I prefer to go back to the basics.
As you say, this could be several things, but you can do some tests to isolate things.
To remove the possibility of flexure or random shifting, ensure your focuser and everything else is firm. secondly, point the scope at the zenith to do your tests. Gravity will not sag your focuser and you should have better seeing looking straight up.
Are you collimated?? if you're not sure if its collimation or tilt causing wonky stars, you can rotate your camera then take another shot and compare. A tilt issue (from the rotation point to the camera) will follow the camera - stay in the same chip position. Collimation will not, it will move to a different place.
The other thing to try, do you own focus runs in the corners of the chip, and one in the middle. Use the best focus position at each off the 5 locations to determine where your chip sits relative to the focal plane. From there you will know what part of the chip need to move in what direction.
Regards
Joshua