Recently, studies have started employing dynamic four-dimensional computed tomography (4DCT) imaging as a biomechanical assessment tool. These studies would benefit from the valuable work that has been done in the past using three-dimensional computed tomography (3DCT). Thus, a structured review was conducted to examine the extent and range of methods employing CT imaging to measure shoulder kinematics. The findings of the review were utilized to conduct a study that employed 4DCT imaging to measure glenohumeral joint congruency and arthrokinematics during internal rotation to the back in a population of healthy individuals. The results of this work show the importance of anterior-posterior translation throughout the motion to achieve maximum range of motion. In conclusion, the use of 4DCT as a biomechanical measuring tool has shown to be a reliable technique in quantifying joint congruency and arthrokinematics of the glenohumeral joint and shows promise for future studies.